We have exciting findings in one of our recent studies using screen-based simulation for global health. I’ve been grappling whether to submit our paper to a traditional journal (where the content will be locked behind a pay wall) or to an open-access journal (where I pay a fee up front to have the paper freely available to everyone). It is far from a straight forward decision. As I researched where our paper should live, I was sad to realize very little has changed in the publishing world in the last 20 years.

In the 1990’s, I developed an algorithm in an attempt to move peer and quality review onto the fledgeling Web. Back then I knew all the idiosyncrasies of scholarly publication and the peer-review process. I truly believed traditional publishers were doomed unless they radically changed their business models. One key assumption I made in developing my algorithm was the cost of an article would move to 99¢. I spent some time trying to commercialize a business around the algorithm, going as far as pitching the idea to Apple Computer.

The business side of the idea was essentially the iTunes Store for scholarly publication. If you think about scholarly publications using the framework of the iTunes model, Academicians are the artists and musicians of science. My predictions have not yet proven to come true.

The publishers remain insistent on an archaic charge structure-asking $40, $50, or even $60 for a single full-text article. They fail to realize the exorbinant prices force readers to: 1) find alternative, free sources of the full text articles or 2) ignore their article completely and find another data source. If the iTunes model was adopted, few would hesitate to pay 99¢ for an article. We have a long way to go.

I would imagine, when iTunes was starting up and Napster was a its peak, the music industry wondered if people would pay for their music. Far from destroying the industry, in 2013, the iTunes store generated more than $16 billion in revenue. Surely, adopting this type of charge structure, publishers would recover more per article than they do today.

Unfortunately, academic promotion is highly intertwined with traditional publication and encourages the status quo. Academicians are not paid directly for their "art.” Instead, career advancement and tenure is highly dependent on the quality of their work. The quality of work is judged by the prestige of the journal where their articles are published. Academia perpetuates the dysfunction by demanding their faculty prioritize submissions to the highest rated academic journals-those controlled by traditional publishers with a vise-like grip.

For the time being, we’re stuck with existing models. Until there is a radical change in the way academia evaluates faculty for promotion and tenure.

Understandably, traditional publishers are hesitant to change the entrenched models of their multi-billion dollar industry. Publishers would do well to pay close attention to Dr. Clay Christensen’s Innovators’ Dilemma, I believe old-school publication is one disruptive innovation away from annihilation. As an example, traditional publishers continue to print their product on paper. Although this is an incredible waste in the digital age, they do so for two main reasons: 1. to continue to sell advertisements and 2. to limit the number of articles published each month— driving their citation indices higher (the citation index is dependent on the number of citations per article in a two year period). Although important, economics are not the only thing that needs to change. The peer-review system needs to be revamped as well.

The current peer review system is both slow and can be biased. Publishing in a traditional journal can take more than a year from initial submission to publication. In addition, today’s system is set up to favor bias and nepotism. Those most threatened by the advancement of a novel or even revolutionary idea, the scientists that built their reputation on the current paradigm, are the ones most likely to be critiquing publications (or grant proposals). In these scientist's defense, it is only human to be skeptical of a new idea that could negate decades of one's own work.

Science wants to be free. Open-access journals are a step in the right direction. Time to publication tends to be much faster and once published, the manuscript is universally accessible. However, many in academia warn against publishing in open-access journals because of their lower citation indices. This is not surprising-the citation index was developed before the digital age. Twitter, social media, and blogs are challenging existing paradigms of what type of impact a publication has had. It is refreshing to see many new attempts, such as Altmetrics, to redefine the impact of scholarly information in the digital age.

As I read online comments about open-access journals such as PLOS One, many seem critical of their publication rate and volume. Unlike traditional journals, PLoS One reviews only for scientific soundness—not for the impact of the ideas. This makes sense to me in the digital age—science wants to be free, not caught up in peer-review.

As I worked through writing this entry, I've realized I'm leaning heavily toward publishing in an open-access journal (or at least pay for open access of the article). I am doing so primarily to make our findings available to the broadest range of readers possible, especially those in Low and Middle Income Countries. Had I not yet been promoted, I would likely choose a traditional publisher for fear of negatively impacting my promotability. It's time for a change!